05D0967878 CLIA NUMBER - PALOS VERDES HEALTH CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0967878
  • Facility Name: PALOS VERDES HEALTH CARE CENTER
  • Facility Address: 26303 S WESTERN AVE
    LOMITA, CA
    ZIP 90717
  • Facility Phone: 310 784-5440
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: AMONON LICHT MD
  • NPI Number: 1104817071
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0967878
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PALOS VERDES HEALTH CARE CENTER
Street 26303 S WESTERN AVE
City LOMITA
State CA
ZIP 90717
Phone 310 784-5440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2023
Certificate Expiration Date 11/23/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director AMONON LICHT MD

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This page was last updated on: 9/29/2025